OK Everybody, Back In The Pool.

Coffee Brown, MD, University of New Mexico, Talk Radio News


Atypical Flu Update 05/06/09
Today’s numbers: 642 cases in 41 states. There are now 2 deaths
reported with one being wholly American. Whereas the first was a
Mexican child who contracted the disease in Mexico, the second, per
WebMD, had no reported connection with Mexico other than living near
the border in Texas. She was young, but had other conditions’
“co-morbidities,” including recent childbirth, obesity, and recent
pneumonia. Counting her as the as the only native fatality so far, the
mortality rate in the U.S. is 0.1 percent.
Worldwide, there 1516 confirmed cases in 22 countries, with 29 deaths
in Mexico out of 822 confirmed cases (3.5 percent mortality), and no
deaths so far reported outside of Mexico and the U.S.
The World Health Organization is still not recommending travel
restrictions, except to advise people who feel ill to stay home.
WHO alert status remains at stage 5. Clusters of cases do not seem to
be occurring yet, which may mean that the virus weakens with time.
Nevertheless, the Centers for Disease Control and Prevention remind us
that we have weeks of this contagion to go yet.
The overall severity of this flu outside of Mexico is “mild to
moderate” per the CDC.
Per Secretary of Health and Human Services Kathleen Sebelius, “School
closing has gotten a lot of attention. There's a balance with the
importance of making sure our children go to school every day. The
virus transmits very quickly child to child, the end result has been a
more mild version of the disease than was originally feared and the
lethality seems at a much less significant level”
The current guidelines are to keep schools open, even if some students
get the flu, as would be done during any normal flu season, she says,
though that makes it even more important to keep symptomatic children
home.
“So we're urging parents to take steps if your child is sick, please
do not send your child to school. If a teacher is sick, please don't
come to school,” sebelius said.
And home means home. “And parents, don't turn around and keep your
child home from school and send him or her to the mall. This is really
about staying home,” Sebelius added.
The recommended period of “grounding” is seven days, even if symptoms
resolve, because that is how long sufferers may remain contagious.
So, did the CDC, WHO and media over-react? This flu is looking less
scary by the day, but it started with a significant number of
fatalities, and it was clearly a very different strain than had been
seen before. While we may start to feel some relief at this point,
these things can change quickly. Washing our hands, avoiding others
when we have symptoms, and insisting on common courtesy (Hey, cover
your mouth when you cough), may help reduce the 35,000 deaths per
year, and billions of dollars in lost productivity we have come to
think of as “normal.”

Pandemic Or What?

Coffee Brown MD, University of New Mexico, Talk Radio News

There are three main differences between a normal flu and a pandemic flu, as described by the Department of Homeland Security: incidence, virulence, and demographics.
Incidence refers to how many of us will get it. In a normal year, about 15 percent of 300 million Americans, or about 45 million people will get infected. In a pandemic, rates rise to 25-50 percent, or 75-150 million cases.
Virulence refers to how many of us will die of the infection. In a normal year, that’s about 0.07 percent, or about 35 thousand out those 45 million. In 1918, mortality was about 2.5 percent, which would be about 7.5 million deaths, given today’s population.
Demographics refers to which of us are at most risk. In a normal year, nearly all deaths occur in people over 65 years old. In 1918 and 1957, mortality was highest among school-aged children and young adults.
This summary, with some calculations, comes from information provided by DHS and presented at GlobalSecurity.Org
Let’s compare the 2009 A-H1N1 Flu. “Atypical flu” may be a handier name. “Swine flu” is passe’.
Incidence: As of 05/02/09: There have been 615 confirmed cases in 15 countries. Attack rates so far are too low and data too incomplete to meaningfully calculate.
Virulence: Mortality in Mexico, the country hardest hit so far, is 16 out of 397 cases: about 4 percent, which works out to four thousand per hundred thousand (a common way of expressing this type of number).
The one U.S. death might properly have been considered a Mexican death, since that child contracted the disease there. If calculated as U.S. data: one death out of 141 cases: about point seven percent. If that fatality is not charged to the U.S. account, the mortality rate outside of Mexico is zero percent as of this writing.
Demographics: Reports say that the Mexican victims were young, but I have not been able to locate details to confirm that. The World Health Organization says that more study would be needed to confirm that younger people are more at risk.
Other: The other elements of this flu that merit precautions are that it is genetically unique, meaning we may have no immunity, and that it is slightly out of season, meaning that it exhibits at least some unpredictable behavior.
We are still at phase 5, so clusters of cases in multiple countries, which would define phase 6, have not yet been confirmed.
Per the WHO, there no travel advisories at this time.
Do masks help? Yes, no, and maybe. Yes: as tiny as viruses are, they could slip right through any screen that we could breathe through, but the virus is carried in droplets of exhaled moisture, and those droplets do stick to the mask. No: But the masks dry, and it’s not clear whether the virus survives and detaches into the inhaled air. Maybe: the real test would be whether people with masks get fewer infections (though such people probably also take more precautions in general), and the Centers for Disease Control and Prevention says that data is not yet available.